Medication Review Flashcards
What is the approximate cost of wasted prescribed medicines each year?
£300m.
How much is spent per year on extra days in hospital due to medication errors?
£500m.
What proportion of regular medicines are not used in a way that is fully effective?
Half.
ADRs are implicated in what percentage of hospital admissions?
5-17%.
What are the 5 rights that should be followed when administering drugs to a patient?
Right patient, right drug, right dose, right route, right time. (Right documentation).
Explain the swiss cheese model of error prevention.
Swiss cheese has holes in it, as such each ‘slice of cheese’ represents one level of error prevention. If layers are removed then the likelihood of errors occurring increases. On top of this, if the ‘holes’ line up then an error can occur.
What are the three levels of medication review?
Level 1 - prescription review. Level 2 - concordance and compliance review (MUR). Level 3 - clinical medication review.
When carrying out a level 3 medication review, one should explain why the review is important and compile a list of all medications. What questions should one aim to answer?
Is there an active diagnosis for each item?
Is drug therapy really necessary?
What are the therapeutic goals?
Has the most appropriate drug been chosen?
Is the drug being used correctly?
Is the drug/disease being monitored appropriately?
In terms of the patient/carers themselves, what should be ascertained by a level 3 medication review?
Their perception of the purpose of the medication, their understanding of how the medication should be taken, whether they can effectively take the medication, if they have any questions or concerns.
Give some causes of unintentional non-adherence.
Problems ordering/receiving repeat prescription, problems with packaging (getting medication out of packs), difficulty reading labels, forgetting to take medicines.
What is medicines reconciliation?
It is a pharmacy technician led activity to obtain ones drug history using multiple sources. A patients allergy status should be checked. Discrepancies should be highlighted for the pharmacist to take action.
As well as drugs, what should be included on a patients medication chart?
Name, age (DOB), gender, hospital number, ward, allergy status (allergic to, what happens), intolerances.
For each item on a medication chart, what must be included?
Name, strength, dose, timing of administration, formulation, route of admission, additional instructions.
When writing units, what should be avoided?
Abbreviations.
What information about the dose should be included?
Can it be administered?
Is it clear and unambiguous?
Has a dose change been dated?
